10 Tips For Testing Hearing in Children With Autism

Introduction: Concerns about the quality of life (QoL) of parents of children with autism spectrum disorder have been raised by previous study. Policy decision-makers and healthcare professionals can be better informed about the environmental factors associated with parental QoL, which will enhance outcomes for both parents and children. The objective of this review is to perform a comprehensive review that assessed the environmental relevant factors associated with quality of life (QoL) of parents of ASD children (under 18 years old). Methodology: To identify the environmental factors associated with parental QoL, a scoping review was conducted using the Arksey and O'Malley original and enhanced framework. Three electronic data bases (PubMed, Scopus & WOS) and reference list checks were used in the search. Results: Social support, family support, residential condition and access to services were all factors linked to parental quality of life in this group. Conclusion: The review clarified environmental factors as one of variables that have association with parental QoL. The results of this analysis also highlighted potential areas of support that have implications on future policy and practices. Keywords : environmental factors, autism spectrum disorder, quality of life, parents, children References CDC. Prevalence of autism spectrum disorders--Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008. MMWR Surveill Summ. 2012;61(3):1-19. CDC. Prevalence of autism spectrum disorder among children aged 8 years - autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR Surveill Summ. 2014;63(2):1-21. Elsabbagh M, Divan G, Koh Y-J, Kim YS, Kauchali S, Marcín C, et al. Global Prevalence of Autism and Other Pervasive Developmental Disorders. Autism Research. 2012;5(3):160-79. McTiernan A, Leader G, Healy O, Mannion A. Analysis of risk factors and early predictors of challenging behavior for children with autism spectrum disorder. Research in Autism Spectrum Disorders. 2011;5(3):1215-22. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry. 2008;47(8):921-9. Bolton PF. Medical conditions in autism spectrum disorders. Journal of Neurodevelopmental Disorders. 2009;1(2):102-13. Khanna R, Madhavan SS, Smith MJ, Patrick JH, Tworek C, Becker-Cottrill B. Assessment of Health-Related Quality of Life Among Primary Caregivers of Children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders. 2011;41(9):1214-27.

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder. Previous surveys have reported a steady increase in ASD prevalence in US children over the past decades. Several behavioral therapies and medications have been developed to treat the symptoms of ASD; however, little is known about the current status of treatment usage for children diagnosed as having ASD. To estimate the prevalence and treatment patterns of ASD among US children using nationally representative data. This study used data from the 2016 National Survey of Children's Health, a nationwide, population-based, cross-sectional survey. We included 43 032 children aged 3 to 17 years. Data were collected through questionnaires completed by a parent or guardian. Data were analyzed from February 2018 to March 2018. Outcome variables included ASD diagnosed by a physician or health professional and the use of behavioral treatment or medication treatment among children with ASD. Of the 43 032 included participants, 22 072 (51.3%) were male, and the mean (SD) age was 10.7 (4.4) years. The weighted prevalence of ever-diagnosed ASD and current ASD were 2.79% (95% CI, 2.46-3.12) and 2.50% (95% CI, 2.21-2.79), respectively. The state-level prevalence of ever-diagnosed ASD varied from 1.54% (95% CI, 0.60-2.48) in Texas to 4.88% (95% CI, 2.72-7.05) in Florida. Nationally, about 70% of children with current ASD (70.5%; 95% CI, 65.1-75.8) were treated; 43.3% (95% CI, 37.4-49.2) received behavioral treatment only, 6.9% (95% CI, 3.7-10.1) received medication treatment only, and 20.3% (95% CI, 16.5-24.1) received both behavioral and medication treatments. The remaining 29.5% (95% CI, 24.2-34.9) of children with current ASD did not receive either behavioral or medication treatment. This study showed that the prevalence of ASD in the United States was relatively high, and it varied substantially across US states. Almost 30% of US children with ASD did not receive behavioral or medication treatment, which calls for a critical need to understand and address the barriers for those children to receive appropriate treatments.

SIG 16 Perspectives Vol. 12, No. 3, October 2011

He could fit in the palms of both hands, seemed to look at you beseechingly while you rushed to thread a vein and snake a tube down a tiny nostril of this 24 week preemie. Already exposed to the prenatal stress that culminated in premature delivery, he has been further exposed to the stress associated with the separation from his mother and multiple medical interventions. Like other premature babies, he is more vulnerable to invasive infections from bacteria and viruses; moreover, the delayed development of his gut-blood-brain barriers could expose him to potential neurotoxins. Such infants are up to 4 times more likely to develop autism. If their mothers had allergies, mastocytosis or an autoimmune disease, this risk almost doubles. Autism Spectrum Disorders (ASD) are pervasive developmental disorders that include Autistic Disorder and Asperger’s Disorder, although Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) is frequently included (Johnson & Myers, 2007). ASD are characterized by variable deficits in social skills, stereotypic behaviors, and a wide range of behavioral and learning problems. ASD manifest during early childhood and at least 30% present with sudden clinical regression of development around 3 years of age (Matson J.L. & Kozlowski A.M., 2010; Zappella, 2010). Over the last 20 years, there has been an impressive rise in ASD with current prevalence estimates of 1/100 children (Fombonne, 2009; Kogan et al., 2009). In the majority of cases, the cause of ASD is unknown (Levy et al., 2009). Some autism susceptibility genes have been identified (Weiss et al., 2009), but gene interactions with environmental factors are increasingly suspected (Deth et al., 2008; Herbert, 2010). Recent reviews have focused mostly on genomic screens that suggest there are multiple gene interactions in autism; however no gene abnormality alone can explain the apparent increase in ASD prevalence (Durkin et al., 2010; Herbert, 2010; Miles, 2011). Increasing evidence suggests that there are different ASD endophenotypes, even within the ASD spectrum (Palmieri & Persico, 2010).

PREPARING SPECIAL EDUCATION TEACHERS IN AUTISM SPECTRUM DISORDERS: REFLECTIONS ON TEACHER QUALITY Amanda L. Mazin The number of students receiving educational services under the classification of autism is increasing (Sack-Min, 2008; Center for Disease Control Autism and Developmental Disabilities Monitoring Network, 2007; Dymond, Gilson, Myran, 2007; Fitzgerald & Ryan, 2006). There is a need to provide better educational opportunities for individuals with autism spectrum disorders (ASD) in schools. One of the clearest needs in the field is to increase the number of well-prepared professionals to work with children and their families. (Simpson, LaCava, Graner, 2004; Palmer, Blanchard, Jean & Mandell, 2005). Learners with ASD can be expected to acquire vital skills, knowledge, and behaviors only when educators are able and willing to adopt and properly use effective practice strategies and methods (Lerman, Vorndran, Addison & Contucci Kuhn, 2004). A Two-Phase Sequential Exploratory Mixed-Method design was used in this study. In the first qualitative phase, seven experts in the field of ASD and teacher education were interviewed to explore the phenomenon quality special education teachers of students with ASD, particularly the areas of knowledge, skill and characteristics. The results of this phase were used to develop a battery of measurement instruments that were used in the second, quantitative phase of the study. During the second phase, 112 special education teachers of students with ASD were surveyed, using the instruments developed in phase one, to investigate correlations and predictive relationships between the dependent variables knowledge of ASD, skill, characteristics quality, self-efficacy and the independent variables number of courses in ASD, highest degree reported, type of certification/endorsement, number of years of professional experiences working with individuals with ASD, number of years of professional experience working with individuals with disabilities, number of students with ASD worked with in professional career, number of current students with ASD, number of years since received highest degree, and self-reported effectiveness of preparation. Correlations and hierarchical regressions for all dependent variables were conducted. Results indicated the best predictors of knowledge of ASD for special education teachers of students with ASD were: number of courses in ASD; highest degree reported; number of years of professional experience working with individuals with ASD; and number of students with ASD worked with in professional career. The best predictors of skill were: number of courses in ASD; number of years of professional experience working with individuals with ASD; and self-reported effectiveness of preparation. The best predictors of self-efficacy were: number of courses in ASD and number of years of professional experience working with individuals with ASD. Lastly, the best predictors of quality special education teachers of students with ASD were determined to be the number of courses in ASD and self-reported effectiveness of preparation

The intersection of autism spectrum disorder and intellectual disability

ABSTRACTPurpose: To conduct a follow-up assessment of the maintenance of communication skills of a 7-year-old child with autism spectrum disorder, 3 years 7 months post PECS training; and investigate the effects of environmental adaptations on the child’s PECS and vocal communications.Methods: An alternating-treatments design enabled comparison of the effects of two treatment conditions (an environmental adaptation to increase need and opportunities for communication, versus a continuation of baseline procedures) on the child’s PECS and vocal communications in the child’s home.Results: Baseline data demonstrated decreased levels of PECS and vocal communication at follow-up, compared to post PECS training 3 years 7 months prior. The environmental adaptation had no observable effect on the participant’s use of PECS, but vocal manding increased in this condition.Conclusion: These results suggest ongoing need for motivating environments with ample opportunities to practice post PECS training. Implications and directions for future research are discussed.

Evidence-based intervention is an effective method for improving autism spectrum disorder (ASD) in children on socialization, behavior, and communication and may have an impact on brain activity. The aim of this study is to find the effectiveness of picture exchange communication system (PECS) and parent-implemented intervention (PII) among ASD children. Sixty ASD children who fulfilled the inclusion criteria were selected and assigned into control (n=30) and experimental (n=30) groups. The experimental group received evidence-based intervention with PECS and PII for 6 months, whereas the control group received routine care. The children were assessed for social relationship and reciprocity (SRR) and speech language communication (SLC) before and after the intervention. For the experimental group, a 3-month post-intervention was also assessed. Parametric and nonparametric statistical methods were used. The data showed that male nuclear family and birth order above 1 was more among ASD. Two-way RM ANOVA showed a significant difference among the groups and tests (P < 0.001) and interaction of groups with tests (P < 0.001). Experimental post-test-2, that is, after 6 months, showed significant improvement in SRR and SLC compared with the control group. The present study shows that the PECS and PII as a nursing strategy can improve ASD children socialization and communication.

Introduction: Children and adolescents with autism spectrum disorder (ASD) appear to be at greater risk of excess weight gain. The aim of this systematic review and meta-analysis was to examine whether children with ASD have a greater prevalence of obesity and whether the prevalence of ASD is higher in children with obesity. Methods: We conducted a systematic search on PubMed, Scopus, and PsychINFO until May 21, 2021. We used the meta package in the R in order to calculate the pooled prevalence and relative risk of obesity in children with ASD. Results: We found 20 eligible studies investigating the prevalence of obesity in children with ASD, with the prevalence ranging from 7.9 to 31.8% and from 1.4 to 23.6% among controls. All but three studies originated from the USA. The proportion of children with obesity in ASD populations was 17% (95% confidence interval [CI]: 13–22). The relative risk of obesity in children with ASD compared with control children was 1.58 (95% CI: 1.34–1.86). There were no controlled studies reporting on the prevalence of ASD in children with obesity. Conclusion: Children and adolescents with ASD have a higher prevalence of obesity than healthy controls. There is a need for further prevalence studies of obesity in children with ASD, especially outside the USA, since the few European studies carried out have failed to show a significant difference between obesity prevalence in children with and without ASD. There is no knowledge at all regarding the prevalence of ASD among children with obesity.

Frequency and Pattern of Documented Diagnostic Features and the Age of Autism Identification

This systematic review aimed to summarize the current evidence on the effectiveness of various psychological behavioural therapies in improving oral hygiene maintenance habits and oral health among children with autism. Independent screening and study selection, data extraction, risk of bias assessment, and evaluation of the certainty of evidence were conducted. A total of 16 studies were deemed eligible for qualitative synthesis, with 9 included in quantitative analyses. Psychological behavioural therapies including visual pedagogies, social stories, components of PECS (Picture Exchange Communication System) and Applied Behavioural Analysis, as well as the use of smart device applications all demonstrated improvement in oral health parameters following implementation. However, most studies lacked control groups and exhibited a high risk of bias due to the lack of reporting or failure to account for autism spectrum disorder (ASD) severity and associated comorbidities. In addition, studies typically relied on caregivers to carry out reinforcement of therapies, which may explain the significant heterogeneity observed. In summary, the evidence supporting the use of psychoeducational techniques to improve the oral health parameters of autistic children is limited and of very low certainty. Further research utilizing larger-scale studies and more rigorous study designs is necessary to enhance the certainty of evidence in this field.Lay abstractThis review looked at existing studies to see how effective different psychological and behavioural therapies are in helping children with autism take better care of their teeth and maintain good oral health. The researchers carefully selected and analysed 16 studies, with 9 of those used for detailed analysis. The therapies examined included visual tools, social stories, parts of the Picture Exchange Communication System (PECS), Applied Behavioural Analysis (ABA), and smartphone apps. Overall, these approaches showed some improvements in oral health. However, many of the studies had weaknesses, such as not having control groups or not fully considering the severity of the autistic conditions or if other medical conditions are present. In short, the current evidence that these therapies help improve oral health in children with autism is limited and not very strong. More high-quality research with larger groups of children is needed to better understand what works best.

Although data on publicly available special education are informative and offer a glimpse of trends in autism spectrum disorder (ASD) and use of educational services, using these data for population-based public health monitoring has drawbacks. Our objective was to evaluate trends in special education eligibility among 8-year-old children with ASD identified in the Autism and Developmental Disabilities Monitoring Network. We used data from 5 Autism and Developmental Disabilities Monitoring Network sites (Arizona, Colorado, Georgia, Maryland, and North Carolina) during 4 surveillance years (2002, 2006, 2008, and 2010) and compared trends in 12 categories of special education eligibility by sex and race/ethnicity. We used multivariable linear risk regressions to evaluate how the proportion of children with a given eligibility changed over time. Of 6010 children with ASD, more than 36% did not receive an autism eligibility in special education in each surveillance year. From surveillance year 2002 to surveillance year 2010, autism eligibility increased by 3.6 percentage points ( P = .09), and intellectual disability eligibility decreased by 4.6 percentage points ( P < .001). A greater proportion of boys than girls had an autism eligibility in 2002 (56.3% vs 48.8%). Compared with other racial/ethnic groups, Hispanic children had the largest increase in proportion with autism eligibility from 2002 to 2010 (15.4%, P = .005) and the largest decrease in proportion with intellectual disability (-14.3%, P = .004). Although most children with ASD had autism eligibility, many received special education services under other categories, and racial/ethnic disparities persisted. To monitor trends in ASD prevalence, public health officials need access to comprehensive data collected systematically, not just special education eligibility.

Symptoms characteristic of autism spectrum disorder were initially believed to protect individuals with autism spectrum disorder from developing substance abuse. However, recent studies suggest that up to 36% of individuals with autism spectrum disorder may have a co-occurring issue with substance abuse. In addition, substance abuse may worsen the difficulties with daily functioning some individuals with autism spectrum disorder experience. It is important to understand occurrence rates, and risk, protective and positive treatment factors of co-occurring autism spectrum disorder and substance abuse in order to promote the best possible support for this special population. This review aimed to find and synthesize evidence regarding risk, protective and treatment factors, and determine a general prevalence rate of co-occurring autism spectrum disorder and substance abuse from all studies on substance use and abuse in individuals with autism spectrum disorder. The review also aimed to assess study quality and identify a diagnostic measure for substance abuse in individuals with autism spectrum disorder. Twenty-six studies on substance use and abuse in autism spectrum disorder were included in the review. The rates of substance abuse among those with autism spectrum disorder identified by included studies ranged from 1.3% to 36%, but due to large differences in study methods, a general prevalence rate could not be determined. Risk and protective factors, recognized in the general population, such as familial substance abuse and co-occurring mental health issues, and factors which may be more likely to occur in individuals with autism spectrum disorder, such as limited social resources and low sensation-seeking, were identified. No diagnostic measures specific to individuals with autism spectrum disorder and substance abuse were identified. This review identified only one exploratory study on an adapted intervention for co-occurring autism spectrum disorder and substance abuse. However, there were many methodological challenges in this study that limit the conclusions that can be drawn from the data. More research, using consistent methods, is needed to understand risk and protective factors and to determine the prevalence of substance abuse among individuals with autism spectrum disorder. The potential for co-occurring autism spectrum disorder and substance abuse should be considered by professional working in both autism spectrum disorder and substance abuse services, as finding suggests substance abuse is possible among individuals with autism spectrum disorder and may occur more frequently than previously believed. In addition, autism spectrum disorder and substance abuse service providers should be sensitive to specific risk and protective factors identified by the review that may impact substance abuse course and outcomes.

Given the prevalence of autism spectrum disorder (1-2%), all primary care pediatricians should be prepared to care for children with ASD and their families. However, children with ASD often have...

Vitamin D and Atopy